Doenças tropicais negligenciadas: caracterização dos indivíduos e distribuição espacial em um município no semiárido do Piauí

Abstract

The study of the occurrence of neglected tropical diseases (NTDs) based on the location of cases and local epidemiology provides data on their distribution, allowing the identification of clusters and understanding at an expanded level, constituting a important management tool in the control and elimination programs. Considering that the majority of NTDs found in the worldoccur in Brazil, a country that has millions of people living at the level of extreme poverty concentrated in Northeast region, this study aimed to perform spatial analysis and characterize individuals diagnosed with NTDs from 2013 to 2018 in the city of Picos, which is a municipality in the semi-arid region of the state of Piauí, northeast region of Brazil. Thus, this research is an ecological, analytical and exploratory study carried out through access to compulsory notification forms contained in the municipality's Epidemiological Surveillance.The final population consisted of 1,532 cases in which descriptive statistics were performed, such as absolute and relative frequencies, proportion ratios and incidence calculations. After verifying the global autocorrelation through the Moran index, the local autocorrelation was evaluated through the LISA (Local Indicators of Spatial Association) using Moran Maps for the spatial representation of the Moran scattering diagram.The results were presented in four axes according to methodological specifications and analyzed diseases. A higher percentage of notified cases of dengue was observed, followed by leprosy and tuberculosis. There was a predominance of cases in female in the reports of dengue, leprosy and schistosomiasis. As for the age group, there is a predominance among adults (20 - 59 years). Most of the notifications pointed out as incomplete elementary schooling, however, the high percentage of ignored in the notifications of dengue cases stands out. The brown race was identified as the majority in all NTD notifications. Only for dengue cases were reported in pregnant women. The reported cases of NTD were concentrated in the urban residence area; however, the incidence is higher in the rural area. Although the highest percentage of cases of tuberculosis and leprosy has been verified in primary care points, thelarge number of notifications in secondary care points stands out. The municipality of showed hyper endemic for leprosy. Regarding dengue, most notifications occurred at the tertiary level. The spatial analysis of the cases located in the urban network showed a cluster of neighborhoods with similar incidence rates in neighborhoods close to the city center. A high-risk cluster was identified in the central neighborhoods of the city, which can help to define the priority areas for specific interventions. The information evidenced in the study on local epidemiology and spatial analysismay contribute to the definition of actions aimed at improving the control and reducing the incidence of NTD cases in the city.